Reference no: EM133664588

Assignment:

PLEASE ANSWER ALL THE QUESTIONS THANKS.

Case 1

Mr. Zeemond, age 46, is an accountant with a strong family history of heart disease. He does not exercise regularly and is 10% overweight. He is getting ready for work when he suddenly feels weak and short of breath, and he has a pressure in his midsternal area. His wife finds him clutching his chest and sitting on the bed. After 10 minutes, he tells his wife it feels like an elephant is sitting on his chest.

1. Why should Mrs. Zeemond call EMS (emergency medical services)?
2. Explain how each of the following tests, ordered in the emergency department, diagnose a myocardial infarction (MI)?
3. Cardiac Troponin:
4. Creatine Kinase- Myoglobin (CK-MB):
5. ECG (Electrocardiogram):
6. The ECG shows anterior wall MI. Which coronary artery is involved in this type of MI?
7. Based on the pathophysiology of myocardial infarctions, why is Mrs. Zeemond is experiencing each of these symptoms?
8. Chest pain:
9. Shortness of breath:
10. Weakness:
11. Explain the benefits of each of the following treatments/interventions.
12. Initial bedrest:
13. Oxygen:
14. Morphine 2mg intravenously (IV). Also explain the significance of the route (IV):
15. Cardiac stent:
16. If Mr. Zeemond was experiencing an inferior MI, which medication precautions or contraindications would need to be taken into consideration and why?

Case 2

Mr. Cowlin is status 4 days post-CABG surgery and has refused to ambulate or perform his a.m. care. You have noticed that he has had a poor appetite and has been fatigued over the past 2 days.

1. Why might Mr. Cowlin be declining to participate in his morning care?
2. What approach might you take to promote Mr. Cowlin's participation in activities of daily living? Explain your reasoning.
3. Your approach was successful in having Mr. Cowlin participate in his care. He is progressing well in his rehabilitation and preparing for discharge. You have been asked to provide teaching on the use of Nitroglycerin PRN for chest pain. Using the resource found in "Other Useful Information" of the Acute MI module, please complete the following questions to get ready for your teaching.
4. What is nitroglycerin and how does it work?
5. Explain how nitroglycerin should be administered (when, how often, etc.).
6. How should nitroglycerin be stored?
7. Are there any side effects or drug-drug interactions to consider in using nitroglycerin?